Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NT60740400 | WA |
NPI | 1003349200 |
---|---|
Provider Name | Courtney Elizabeth Burkhart Addabbo |
First Address | Shoreline, WA 98133-6343 |
Second Address | Puyallup, WA 98371-4313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2017 |
Last Update Date | 23/01/2020 |